This continuation application is submitted by the GWUMC investigators in response to LOI #HD-03-106, released June 10, 2003, by the NICHD. The GWUMC investigators intend to collaborate with investigators from other sites in this cooperative agreement towards the goal of the NICHD to examine ways to maximize health and healthy behaviors in a minority population of mothers and children. Smoking during pregnancy continues to be a significant public health problem and is the foremost preventable cause of perinatal morbidity and mortality. Strong evidence exists for adverse effects on the mother, the fetus and the infant. The focus of this application is to address the risk of nicotine exposure to the fetus and during infancy, this risk factor is considered a continuum impacting both health and development in later life. The GWUMC investigators are submitting two concept papers that aim to test the efficacy of innovative intervention methods tailored to reduce fetal and infant exposure to nicotine secondary to maternal smoking and environmental tobacco exposure. The specific aims of the first concept entitled, "The Efficacy of Nicotine Replacement Therapy to Reduce the Risk of Nicotine Exposure in Pregnant Minority Smokers" include: #1- Conduct a qualitative study among pregnant participants to identify barriers and facilitators of using transdermal nicotine patches as a method to quit smoking while pregnant. #2- Conduct a randomized clinical trial to determine the efficacy of a behavioral intervention plus transdermal nicotine compared with a behavioral intervention only among pregnant minority women who are heavy smokers. The specific aims of the second proposed concept entitled, "Prevention of Environmental Tobacco Smoke (ETS) Exposure in Children Age 0-12 Months" include: #1- Assess the frequency and types of health effects, major and minor, associated with prenatal and postpartum exposure to tobacco smoke products (TSP) and environmental tobacco smoke (ETS) among infants. #2- Develop and test the efficacy of a brief, clinic-based intervention to prevent ETS exposure during infancy that is consistent with clinical practice guidelines. The George Washington University Medical Center with its Schools of Medicine and Health Sciences and School of Public Health and Health Services and its active clinical and research sites is a suitable environment to investigate this significant public health problem in collaboration with other academic sites in the district. The investigators collaborating on this application cover a wide s spectrum of expertise in pediatrics, neonatal medicine, high-risk maternal and fetal medicine, pharmacology, health behavior and clinical psychology. Through this application they will demonstrate a strong academic track record in the area of interest and a track record of effective collaboration during phases I and II of the NIH-DC Initiative to Reduce Infant Mortality.